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Comparison of Clinical Results and Second-Look Arthroscopy after Anterior Cruciate Ligament Reconstruction using Hamstring Tendon Autograft, Mixed graft and Tibialis Tendon Allograft (자가슬괵건, 혼합건 및 동종 경골건을 이용하여 실시한 전방십자인대 재건술후 임상결과 및 이차관절경 검사 비교)

  • Cho, Jin-Ho
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.1
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    • pp.18-26
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    • 2011
  • Purpose: This study is to compare the clinical results of ACL reconstruction between three groups using hamstring tendon autograft, mixed and tibialis tendon allograft. Materials and Methods: Between August 2003 and August 2008, we analyzed 169 cases of ACL reconstruction, 66 cases used hamstring tendon autograft, 42 cases used mixed graft and 61 cases used tibialis tendon allograft, with a minimum follow-up of 12 months. For the clinical evaluation, we evaluated the Lysholm score, Telos stress test device and IKDC score. Results: The average side to side difference in Telos stress test decreased from $7.5{\pm}1.0$ mm to $1.6{\pm}1.0$ mm in autograft group, from $7.6{\pm}1.1$ mm to $1.4{\pm}1.1$ mm in mixed graft group and from $7.4{\pm}1.3$ mm to $2.5{\pm}1.3$ mm in allograft group. The average Lysholm knee score improved from 58.6 to 92.3 in autograft group, from 60.6 to 92.6 in mixed graft group and from 55.3 to 91.5 in allograft group. There was no significant difference between three groups in clinical results. At second look arthroscopy, tension of ligament and synovial coverage were good result in autograft and mixed graft than allograft group. Conclusion: All hamstring tendon autograft, mixed graft and tibialis tendon allograft groups showed satisfactory clinical results, with no significant difference in outcomes between the groups. Both hamstring tendon autograft and mixed graft showed good synovial coverage in second look arthroscopy. So mixed graft will be considered as good alternative in case of shorter or thin harvested hamstring tendon.

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Diagnostic and Therapeutic Utility of Ultrasonography-guided Facet Joint Block in Chronic Cervical Spinal Pain (만성 경추 동통 환자에서 초음파를 이용한 후관절 차단술의 진단 및 치료적 유용성)

  • Kim, Tae Kyun;Shim, Dae Moo;Oh, Sung Kyun;Choi, Byong San;Han, Sang Su
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.54-58
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    • 2010
  • Purpose: In patients with chronic cervical pain, the facet joint is the source of the majority. Due to the difficulty of identifying the exact location of the joint that causes these symptoms, the possibility of complications and the placebo effect brings clinical application into question. In this study, we assessed the prevalence of patients with chronic cervical pain and report the diagnostic and therapeutic usefulness of ultrasonography - guided facet joint block therapy. Materials and Methods: Patients with nonspecific chronic cervical pain for more than 6 months were selected. Patients with disc herniation, sciatica-related pain were excluded from the study and 160 patients who failed in conservative treatment (physical therapy, chiropractic therapy, medication) were included in the study. Diagnostic Ultrasonography-guided facet joint block was performed with 1% lidocaine, and after two weeks, Bupivacaine 0.25% was used in patients who tested positive for lidocaine. Patients with more than 75% pain reduction during movement after facet joint block were considered positive. Results: Among the 160 patients with chronic cervical pain, 96 patients(60%) had a positive reaction after facet block using lidocaine. Among the 64 patients with a negative reaction to lidocaine, 48 patients(75%) had a positive reaction to bupivacaine. There were 48 false positive patients(50%) who showed a positive reaction to lidocaine but a negative reaction to bupivacaine. The mean VAS of the total 160 patients before blocks was 8.5, after 2 weeks follow up it decreased to 2.7 (p = 0.001) and after 4weeks 3.6 (p = 0.001). The 8 patients as an initial improvement of symptoms are not satisfied with the procedure and the 3 patients had been worsened during observation, were showed pain relief after additional ultrasonography-guided facet joint block at 4th week. Conclusion: A single ultrasonography-guided block to chronic cervical pain patients has relatively low diagnostic value since high false positive rate. The twice facet joint blocks is thought to be a useful method for interventional pain management of patients with chronic cervical pain.

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Distribution Characteristics and Management Plan of the Wisteria Habitat (No. 176 natural monument) of Beomeosa Temple in Busan (부산 범어사 등나무군락지의 등나무 분포 특성 및 관리방안)

  • Lee, Chang-Woo;Oh, Hae-Seong;Lee, Cheol-Ho;Choi, Byoung-Ki
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.35 no.2
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    • pp.77-86
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    • 2017
  • A study on the population ecology of gregarious Wisteria habitat was conducted in Beomeosa temple, Busan. The area has been protected since it was designated as No. 176 natural monument in 1966. Such a large habitat of native wisteria (Wisteria floribunda DC.) in Korea is very rare so that it has a very high academic value. However, there are no high-resolution researches on the distribution and ecology of wisteria in the Gregarious Wisteria Habitat of Beomeosa Temple. The study aimed to identify the distribution and characteristics of wisteria populations in the Wisteria habitat. The study identified the distribution of Wisteria, RCC, the climbing direction, the plant and flora in the research area in the Gregarious Wisteria Habitat of Beomeosa Temple in Busan and the surrounding areas based on an on-site research. As a result, the total number of the wisteria populations in the research area was confirmed to be 1,158 and the RCC of wisteria was on average 69.0 mm (${\pm}45.5$) and in maximum 365 mm. In terms of the climbing direction, the number of wisteria that climbs clockwise or counterclockwise was determined to be 40. It was identified that there are 28 taxa of the climbing plant species and the wisteria of the same kind was the most favorable. The populations were found to be dispersed adjacent to the valleys, and were found to be maintained by constant disturbance. 76.6 % of the population was found to be distributed in the valley forest, and the Carpinus tschonoskii-Pseudosasa japonica forest, Pueraria lobata community and Pinus densiflora forest were found to be relatively dispersed. The study proposed to conduct the follow-up researches to preserve the wisteria that is spreading in this research area, the wisteria with the highest RCC and regional habitat through continuous monitoring; and maintain the protection area of No. 176 natural monument; and discussed the management measures and approaches that reflect the habitat.

Effect of Artificial Shade Treatment on the Growth and Biomass Production of Several Deciduous Tree Species (인공피음처리가 주요 활엽수종의 생장과 물질생산에 미치는 영향)

  • 최정호;권기원;정진철
    • Journal of Korea Foresty Energy
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    • v.21 no.1
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    • pp.65-75
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    • 2002
  • The study was carried out to determine the growth and biomass production of major deciduous trees including Betula platyphylla var. japonica, Betula schmidtii, Zelkova serrata, Acer mono, Prunes sargentii, and Ligustrum obtusifolium subjected to artificial shade treatment in nursery field. The six deciduous trees seedlings grow for 2 years under different light intensity of 100%, 38-62%, 22-28%, 7-20%, and 2-6% of the full sun light intensity. The results were as follows; In the seedling heights and root collar diameters of shade intolerant species like Betula platyphylla var. japonica and Betula schmidtii, the relative growth rates of seedlings grown in full sun showed 2 times as compared with those subjected to the shade treatment of 2-6% light intensities of full sun. In the shade tolerant species like Acer mono ant Ligustrum obtusifolium, the growth performances were better in the seedlings grown in 38-62% light intensities of full sun. Total dry mass including the dry mass of leaves, shoot and root were as a whole decreased with shade treatment. The ratio of the dry mass of leaves and stem increased the dry mass of root. T/R ratio of the seedlings increased by decreasing the relative light intensity. And the T/R ratio of 2-6% light intensities of full sun was ranged from 1.1~5.0 were greater in the full sun light was ranged from 0.6~3.2. Light intensity by artificial shade treatment decreased in deciduous trees when compared on the whole, it showed tendency that SLA increases, increased that seeing resemblant tendency in LAR and LWR and changed of light intensity is strong, it increased that showed difference as statistical. But, LWR of Betula platyphylla var. japonica increased gradually and showed tendency that decreases rapidly in the shade treatment of 2-6% light intensities of full sun. This result is thought that biomass production decreased by shading treatment influenced in physiological characteristics such as leaf area and decrease of the leaf amount.

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Soft Tissue Malignant Myoepithelioma in the Extremities (사지에 발생한 연부 조직 악성 근상피종)

  • Kong, Chang-Bae;Lee, Jung-Wook;Koh, Jae-Soo;Song, Won Seok;Cho, Wan Hyeong;Jeon, Dae-Geun;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.54-59
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    • 2014
  • Purpose: We report the diagnosis, treatment outcomes and prognosis of the patients with soft tissue malignant myoepithelioma in the extremities. Materials and Methods: We retrospectively reviewed 6 patients with soft tissue malignant myoepithelioma in the extremities who were treated at our institution between 2008 and 2014. Two patients received unplanned excision at another hospital and remaining 4 patients underwent the biopsy procedures and received wide excision at our hospital. Results: There were 3 men and 3 women with mean age of 41 (33-54) years. The average follow up was 28 (9-45) months. Among the 6 patients, only 4 patients underwent biopsy procedures under the impression of malignant soft tissue sarcoma. Surgical margins for these 4 patients were negative. Two patients who had unplanned excision received another re-excision and one of them showed no residual tumor in the resected specimen. Local recurrences were developed in all patients and distant metastasis in 4 patients. All 4 patients who developed distant metastasis died due to disease progression. Among the 2 patients who developed local recurrence only, one patient has another local recurrence after re-operation and remaining one patient is no evidence of disease for 2 years after resection of locally recurred mass. Conclusion: Soft tissue malignant myoepithelioma in the extremities is a rare disease and shows an aggressive behavior. Appropriate biopsy under the impression of soft tissue malignancy is necessary and complete surgical resection with wide margins is the recommended treatment of choice.

The Result of Bone Grafting for Fibrous Dysplasia (섬유성 골 이형성증에서 시행한 골 이식술의 결과 분석)

  • Jeong, Won-Ju;Kim, Tae-Seong;Cho, Hwan-Seong;Yoon, Jong-Pil;Park, Il-Hyung
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.74-79
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    • 2014
  • Purpose: Fibrous dysplasia is related to the mutation of gene encoding the alpha-subunit of a signal-transducing G-protein and has variable clinical course. Operation can be performed to prevent functional disorder or structural deformity. After curettage, autologous bone graft were used to fill the defects after curettage. The aim of this study is to compare the result of autogenous cancellous bone grafting and allogenic bone grafting for fibrous dysplasia. Materials and Methods: Among the patients who visit our hospital during the period of April, 1997 to October, 2013, we selected 34 patients who diagnosed fibrous dysplasia and visited our clinic over 1 year. There were 13 males and 21 females. Average age was 26.4 (range 2 to 57) years old. Autogenous bone graft (group I) in 5 cases, Non-autogenous bone graft (group II) in 30 cases. Iliac bone is used in all cases of autogenous bone graft. There were no significant difference in age, follow-up period, preoperational laboratory finding between two groups. Radiographic image was done to evaluate the recurrence of fibrous dysplasia or secondary degeneration. Results: There were four cases in recurrence (group I: 1 case, group II: 3 cases, p=0.554). In all recurrent cases, reoperations were done using curettage and autogenous iliac bone graft. There was no re-recurrence after reoperation. One case of secondary aneurysmal bone cyst was confirmed (group II) and 1 cases of pathologic fractures had developed (group I: 0 case, group II: 1 cases, p=0.559). No malignant change occurred. Conclusion: There were no significant difference between autogenous bone graft group and non-autogenous bone graft group. Our result suggested that autogenous bone graft seems to be good method to treat fibrous dysplasia, in the case of small volume of tumor lesion or non-weight bearing portion.

A Study on Basic Plan for Upscaling Environmental Conservation Value Assessment Map(ECVAM) of National Land in South Korea (대축척 국토환경성평가지도 작성방안 연구)

  • Lee, Moung-Jin;Jeon, Seong-Woo;Lee, Chong-Soo;Kang, Byung-Jin;Song, Won-Kyong
    • Journal of Environmental Policy
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    • v.6 no.3
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    • pp.115-145
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    • 2007
  • This study was performed for developing upscaling Environmental Conservation Value Assessment Map(ECVAM) of National Land in South Korea and presenting the application method of ECVAM. This ECVAM adopted the least indicator method and uses a Geographic Information System(GIS). This map is made through evaluation of 67 items. As a result, the construction of ECVAM was defined as a process of identifying land use to scientifically assess the physical and environmental value of land and classify conservation value into several grades for the sustainable management of environmental resources. After applying ECVAM criteria of five degrees to the whole of study area, Grade I, showing the highest conservation value, accounted for 29.3% by land area of ECVAM. Grades II, III, IV and V likewise accounted for, respectively, 21.7%, 17.2%, 7.1% and the lowest conservation value of 24.7%. other result, ECVAM and land suitability assessment agreement rate is Grade I 33.05%, Grades II, III, IV and V likewise accounted for 12.92%, 15.05%, 36.93% and last value of 53.28% This study set up "the realization of the improvement ECVAM" as the vision of the advancing strategy. In order to accomplish the vision, this study established the purpose as follow; constructing strategic assessment value relation to ECVAM based on knowledge, arranging the foundation to upscaling assessment value And this study devised preparatory plans to achieve the vision and the purpose as next; construction on base theme map by 1:5,000 scalie, base on land register theme map and precision land cover map. Therefore, for applying the result of this study to the upscaling Environmental Conservation Value Assessment Map(ECVAM), it considers regularly the systematic categorization of preceding item, consideration issue of national environmental geographic information using the ECVAM.

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A Study on Factors Influencing The State of Adaptation of The Hemiplegic Patients (편마비 환자의 퇴원후 적응상태와 관련요인에 대한 분석적 연구)

  • 서문자
    • Journal of Korean Academy of Nursing
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    • v.20 no.1
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    • pp.88-117
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    • 1990
  • The purposes of this study are to delineate a profile of the state of a stroke patient's adaptation at 3 months after hospitalization and to explore the relationship between the level of adaptation and the variables which influence the adaptation of hemiplegic patients. To these ends, theoretical framework was derived basically from the stress adaptation model. The basic assumption underlying the level of adaptation is influenced by the presenting focal, contextual and residual stimuli. This group of stimuli is further operationalized and represented by a perception of stress. which is the perceived effect of the disability and by the mediating variables such as sociodemographic factors as an external conditioning variables and perceived social support and hardiness personality characteristics as an internal intervening variables. The dependent varibales in this study is the level of physical, psychological and social adaptation and is hypothesized to be a function of the interaction between 3 sets of variables namely, the perceived disability effect, external conditioning variables and internal intevening varibles. A total of fourty three subjects from 3 general hospitals in Seoul were observed and interviewed with the aid of 7 structured instruments. The data were collected twice on each subject : first at the pre-discharge period arid at 3 months post-discharge from hospital for the second time. The study was carried out for the period from February to August, 1988. The instruments used for the study include 4 existing scales and 3 scales developed by the researcher for this study. They are : 1) The ADL dependency scale and the scale of the clinical physical functions for the assessment of physical adaptation. 2) the SDS(self report of depression) to measure the level of psychological adaptation. 3) The scale for the amount of social activities for the measurement of the level of social adaptation. 4) The scale for the perceived effect of disability for the measurement of the focal stimuli. 5) The health related hardiness scale and the perceived interpersonal support self evaluation list(ISEL) for the measurement of the hardiness personality character and the perceived social support. The data obtained were analyzed using percentage, oneway ANOVA, Pearson coefficients correlation and stepwise multiple regression. The findings provide valuable information about the present level of physical adaptation at 3 months after discharge. The patient revealed a decreased ADL dependency and lowered limitation of physical function as compared with pre - discharge state. Psycholcgically, the average degree of depression at follow up was within normal range of depression. Socially, the amount of social activities was very low. The one way ANOVA and the correlational analysis revealed the relationship between the 3 sets of variables and the adaptation level as follows : 1) The perceived disability effect was related to the degree of the depression and the amount of social activities but was not related to the physical adaptation. 2) Among the sociodemographic variables, sex and education were related to the difference of ADL dependency and the change of physical function. These factors indicate that women more than men and educated more than the less educated were found more independent. The education was also related to the degree of depression suggesting that the higher the educational level, the more well adapted the patients were both physically and psychologically. Age, marital status and job state were not found to be related to the patient's adaptation level. 3) Among the internal intervening variables, the health related hardiness characteristic was related to the differences of ADL dependency, physical functions and the social activities, indicating that the higher the hardiness character the higher the level of physical and social adaptation. 4) The perceived social support, another internal intervening variable, was related to the degree of depression and the social activities. This data suggest that the higher the perception of social support, the better adapted the patients were psychogically and socially. In summarizing the results of the correlational analysis, the level of physical adaptation was influenced by sex, the years of education and the hardiness character. The level of psychological adaptation was influenced by the years of education, the perceived disability effect and the perceived social support. And the level of social adaptation was influenced by the perceived disability effect, the hardiness character and the perceived social support. The stepwise multiple regression analysis shows findings as follows : 1) The most important factor to explain the difference of ADL dependency was sex, indicating females were more independent than males. 2) The most important factor to explain the difference of physical function and the degree of depression was the patient's education level. 3) The strongest explaining factor for the amount of social activities was perceived self esteem(one of the subconcepts of perceived social support). Thus the most important factors influencing the level of adaptation were found to be sex, education, the hardiness character and self esteem. From the above findings, the significance of this study can be delineated as follows : 1) Corroboration of the assumed relationship between the various variables and the adaptation level as suggested in the conceptual model. 2) Support for the feasibility of the cognitive approach for nursing intervention such as hardness character training, counselling and teaching for self-care in the chronic patients.

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The Effect of Argon Laser on Periodontal Disease (치주질환에 대한 Argon 레이저의 효과)

  • Ahn, Hyung-Joon;Ryu, Ji-Won;Kim, Jae-Hong;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.277-285
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    • 2005
  • The purpose of this study was to evaluate photothermal effect of laser, which eliminates and reduces bacteria causing periodontal disease, on treatment of periodontal disease. This study included subjects with moderate periodontitis who visited the Department of Oral Medicine, College of dentistry, Yonsei University. The subjects were divided into experimental group, where Argon laser treatment was used, and control group, where conventional subgingival curettage was used. Gingival fluids from each subject were collected prior and after 1 week of the treatment, and changes in number of bacterial colonies cultured from aerobic as well as anaerobic bacteria responsible for the periodontal disease, and changes in clinical indices related to the periodontal disease, such as plaque index, gingival index, sulcus bleeding index, were analysed. As a result, the number of bacterial colonies of aerobic and anaerobic bacteria reduced after 1 week of the treatment in both groups, especially the bacterial colonies of anaerobic bacteria which showed statistically significant reduction(p<0.1). However, there was no significant difference between the experimental group and the control group. Clinical indices including plaque index, gingival index, sulcus bleeding index were reduced after 1 week of the treatment in both groups. In the experimental group, gingival index(p<0.1) and sulcus bleeding index(p<0.01) showed significant reduction, and, in the control group, sulcus bleeding index(p<0.01) showed significant reduction. However, there were no significant differences in each indices between the two groups. The above results suggest that Argon laser could be used as a substitute of conventional subgingival curettage, or in combination with subgingival curettage which would increase the effect of the treatment. Although the possibility of clinical application of Argon laser was observed in this study, more randomized-controlled research, including acquirement of sufficient samples as well as long-termed follow up, would be necessary before clinically effective application of Argon laser.

Chemical Compositions of Fermented Codonopsis lanceolata (발효더덕의 화학성분)

  • Park, Sung-Jin;Seong, Dong-Ho;Park, Dong-Sik;Kim, Seung-Seop;Gou, Jing-Yu;Ahn, Ju-Hee;Yoon, Won-Byung;Lee, Hyeon-Yong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.3
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    • pp.396-400
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    • 2009
  • Dodok (Codonopsis lanceolata Bench. et Hook) root contains abundant pharmaceutical substances and is widely used as a food and a medicinal herb. To identify the major components, fermented Codonopsis lanceolata was analyzed for its chemical compositions prior to their pharmaceutical substances, which were used as the fundamental data. The contents of carbohydrate, crude protein, crude lipid and ash are 79.3%, 13.0%, 2.40% and 5.3%, respectively. The calories of fermented Codonopsis lanceolata was 390.5 kcal. Total dietary fiber was 47.4% of total carbohydrates. The protein was composed of 18 different amino acids. The contents of essential and non-essential amino acids were 8,118.18 mg and 10,913.42 mg. The K was the largest mineral followed by P, Ca and Mg, which means fermented Codonopsis lanceolata is alkali material. The contents of saturated fatty acids, monounsaturated fatty acids and polyunsaturated fatty acids were 37.76%, 3.84%, and 35.64%, respectively. Therefore, the amount of the total unsaturated fatty acid was higher than that of any other plant. The content of crude saponin in fermented Codonopsis lanceolata was 60.1 mg/g. It is expected that a follow up study on fermented Codonopsis lanceolata through development and evaluation of processed foods for their functional properties would provide useful information as a source of medicinal foods.